Alcoholic Neuropathy and its effects on Amputation Rates

Dr Bill Releford
January 27, 2022

Individuals who drink alcohol in excess and have been diagnosed with alcohol use disorder are likely to have alcohol neuropathy. While alcoholic neuropathy is usually not life-threatening, it significantly reduces the quality of life. Worse still, this condition potentially leads to other health issues like lower limb amputation, which often leads to premature death. Below, we shine more light on alcoholic neuropathy and its effects on lower limb amputation.

What is Alcoholic Neuropathy?

Alcoholic neuropathy refers to the condition where peripheral nerves suffer permanent damage due to excessive use of alcohol. It is estimated that 65% of Americans diagnosed with alcohol use disorder also suffer alcoholic neuropathy. Individuals with alcoholic neuropathy often experience numbness, prickly sensations in the limbs, hyperalgesia, and allodynia.

In addition to these symptoms, alcoholic neuropathy results in muscle spasms and cramps, loss of muscle functioning, muscle weakness and atrophy, and other movement disorders. People with alcoholic neuropathy have difficulties moving about, and it is safe to say they do not meet the required mobility and physical activity levels.

Despite its pervasiveness, there is no reliable therapy for alcoholic peripheral neuropathy. Treatment for this condition involves focusing on the problem of alcohol use, and patients may need inpatient rehabilitation to help them stop drinking. Otherwise, any other form of treatment only helps manage the neuropathic pain caused by alcoholic neuropathy.

Alcoholic Neuropathy and Limb Amputation: What’s the Connection?

The danger of alcoholic neuropathy is that it is among the most common but least recognizable effects of heavy alcohol consumption. While alcoholic neuropathy does not directly result in the amputation of lower limbs, it often results in conditions that are risk factors for amputation.

While Black and African American people have the lowest prevalence of heavy drinking, they are still in danger of suffering lower limb amputation due to associated effects. Let’s discuss the various effects of alcoholic neuropathy on lower extremity amputation.

Decreased Sensation

Alcoholic neuropathy damages sensory nerves, which results in the reduced sensation of the limbs. To many people, this may not be alarming. Yet, the loss of sensation could have serious repercussions. Perhaps the most serious is the frequent bumps and scrapes. People with diminished sensation are more likely to suffer minor injuries to the lower limbs.

Due to the absence of discomfort and normal pain, people with alcoholic neuropathy may not notice any tender sores or wounds on their feet. If left unprotected, such sores and wounds could become infected, or the individuals could suffer even more injury. In some cases, repeated trauma may cause such wounds to become chronic, increasing the risk of amputation.

Decreased Mobility and Physical Exercise

Alcoholic neuropathy results in hyperalgesia and allodynia. The former is characterized by increased sensitivity to pain, while the latter is a condition where normal stimulus such as a soft touch produces pain. Undoubtedly, pain is often a common symptom among alcoholic neuropathy patients. In some severe cases, patients experience spontaneous burning pain.

Sometimes, pain due to alcoholic neuropathy can be incapacitating. What’s more, having diminished sensory skills means that patients find it challenging to coordinate walking and other fine motor skills. Muscle weakness and the loss of muscle function also lead to weakness of the lower limbs, which impairs mobility.

Patients with reduced mobility are less likely to be physically active – they can hardly engage in forms of physical activity like brisk walking, jogging, or running. In turn, this may lead to poor circulation to the lower extremity. If such risk factors for amputation are not averted, patients could potentially lose their lower limbs.

Reduced physical activity coupled with poor dietary habits could also lead to peripheral artery disease – a major cause of lower limb amputation. While alcoholic neuropathy is not a direct cause of PAD, it may lead to conditions that result in lower limb amputation.

Heavy Drinking, Neuropathy, and Diabetes

Diabetes is a well-known risk factor for limb amputation. But is there a connection between heavy drinking and diabetes? While more research on the diabetogenic effects of alcohol is needed, there are various ways in which excessive drinking can contribute to conditions that result in diabetes.

Regular heavy drinking is linked to reduced sensitivity to insulin, which can lead to type 2 diabetes. Heavy drinking may also cause chronic pancreatitis, which may, in turn, result in diabetes. Further, excessive drinking of alcohol can exacerbate certain diabetes-related lipid abnormalities. For instance, it may lead to elevated triglyceride levels, lower levels of low-density lipoprotein cholesterol (LDL), and increased levels of high-density lipoprotein (HDL) cholesterol. These lipid abnormalities can increase the chances of developing cardiovascular disease.

Heavy alcohol consumption and diabetes are common causes of peripheral neuropathy. More research is required, but studies have suggested that heavy drinking and diabetes can aggravate or compound the nerve-damaging capability of the other. What’s more, diabetics with alcoholic neuropathy may be at an even higher risk of lower limb amputation if they develop diabetic foot ulcers.

Bottom Line

Prolonged heavy drinking can cause peripheral nerve damage, a known risk factor for amputation. Particularly, decreased sensation could lead to the development of chronic wounds on patients' feet, putting them at risk of amputation. Reduced mobility, decreased physical activity levels, and the alcohol-diabetes connection also put patients at risk of losing their lower limbs.